H. Ohuchi et al., Global myocardial ischemia as a complication of an acute type A aortic dissection - Rapid diagnosis of a case by transesophageal echocardiography, JPN CIRC J, 64(7), 2000, pp. 533-536
Citations number
23
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
A 36-year-old female was admitted for severe chest pain followed by profoun
d shock. Electrocardiography showed severe ST segment depression (0.5-0.7 m
V) in all leads except aVR and aVL. Echocardiography revealed an intimal fl
ap in the ascending aorta and coexisting, grade 3 aortic regurgitation. She
was immediately intubated and transferred to the intensive care unit. Tran
sesophageal echocardiography (TEE) demonstrated an intimal tear at 2 cm abo
ve the sinotubular junction, and the ostium of the left main trunk was oppr
essed by the intimal flap during diastole. Emergency graft replacement of t
he ascending aorta and aortic hemiarch concomitant with aortic valve resusp
ension was performed successfully. The ECG changes reversed to normal immed
iately after the operation. The patient was extubated 2 days postoperativel
y and discharged from the hospital 14 days postoperatively, TEE is useful f
or the rapid evaluation of coronary malperfusion as a complication of acute
aortic dissection, especially in patients with hemodynamic instability.